Turmeric is a staple in many Indian and South Asian households, including mine. I have been exposed to turmeric for as long as I remember, wether it is in a curry or used as a medicine. Both my mother and grandmother would tell me about the many benefits of turmeric. Curcumin is one of the main component that makes up turmeric. It contains many pain relieving, anti-inflammatory and detoxifying characteristics. Interestingly turmeric has been shown to improve memory in those with Alzheimer’s disease.

The brain is made up of many nerve cells which form connections with each other in order to communicate. These nerve cells group together and form distinct brain structures. Each structure is responsible for different functions such as memory, thinking and behaviour. These nerve cells are affected in Alzheimer’s. Alzheimer’s disease is a late onset disease which causes a loss of cells in the brain structures which are responsible for memory as well as cognitive skills. Although the exact reason as to why these nerve cells die are not known, it is suspected to be due to a protein called beta-amyloid which forms plaques as well as tangles of a protein called tau. These build up between these cells and prevent communication between the cells. This causes the cells to die in the specific structures, therefore the individual looses function resulting in loss of memory or cognitive ability. Although currently there is no cure for Alzheimer’s, only treatments which prevent the progression of the symptoms and improve the quality of life.

Turmeric has been used for its medicinal benefits for many years in Ayurvedic, Siddha and Unani medicines. However it has also been shown to be effective in both animals and humans in many other diseases. Turmeric has been linked to increased cognitive function in many studies, in which those who consume more curry, which contains turmeric, perform better in cognitive function tests. As mentioned previously, one of the prominent feature of Alzheimer’s are the beta-amyloid plaques. Turmeric possesses the ability to enter the brain and bind the the beta-amyloid, therefore blocking the formation of the plaques. Interestingly turmeric can also increases phagocytosis of beta-amyloid, hence successfully decreasing the amount of plaque in the brain of an individual with Alzheimer’s. Turmeric also has an anti-inflammatory property, this may have a beneficial effect in those with Alzheimer’s as turmeric can reduces the inflammation of nerve cells that occur in patients. Turmeric achieves this by reducing the amount of inflammatory chemicals that are found in the brain. Turmeric’s anti-oxidant properties also aid to reduce the symptoms of Alzheimer’s created by oxidation.

Curcumin, the main active ingredient in turmeric shows very promising results in decreasing the symptoms of Alzheimer’s and therefore providing the individual with a better quality of life. However it should be noted that these results do not suggest that consuming turmeric will definitely improve symptoms of Alzheimer’s. Although these findings suggests turmeric can be beneficial, a lot more research will be needed in order to make definitive conclusions.

References/further reading

Hishikawa, Nozomi, et al. “Effects of Turmeric on Alzheimer’s Disease with Behavioral and Psychological Symptoms of Dementia.” Ayu, vol. 33, no. 4, 2012, pp. 499–504, www.ncbi.nlm.nih.gov/pmc/articles/PMC3665200/#sec1-3title, 10.4103/0974-8520.110524. Accessed 18 Feb. 2021.

Mishra, Shrikant, and Kalpana Palanivelu. “The Effect of Curcumin (Turmeric) OnAlzheimer′S Disease: An Overview.” Annals of Indian Academy of Neurology, vol. 11, no. 1, 2008, p. 13, www.ncbi.nlm.nih.gov/pmc/articles/PMC2781139/, 10.4103/0972-2327.40220. Accessed 14 Nov. 2019.

There is a strong link between mood and dementia. People who have previously suffered with depression have a higher likelihood of developing dementia and depression is also linked with a faster rate of deterioration in those living with dementia.

Dementia is unique in the way it affects every aspect of an individual’s life and the concurrent presence of depression can add further torment and troubles to an already challenging condition. In the earlier stages of dementia, low mood and depression are relatively common. The reason behind this is multifactorial and thought to be a combination of an increased susceptibility to a recurrence of past depression, insight into one’s condition and prognosis having an effect on mood, and directly due to the various pathophysiological changes of the brain that happen with dementia.

Fortunately, having depression alongside dementia doesn’t mean the depression is simply left untreated. In fact, there are many treatments available for those suffering from depression. This will be tailored to an individual and depend on the severity of the depression and dementia. The biggest challenge though is identifying the low mood in the first place. Communication limitations can make this challenging and signs can be misconstrued as being generally part of the dementia.

Initially, non-pharmacological approaches are considered best. This may include behavioural approaches which teach the main caregiver behavioural strategies to alleviate the depression in the person they care for, mainly involving improving and increasing the number of pleasant events and activities provided by the caregiver for the sufferer. Additionally, support groups can be of great benefit in managing depression, as well as being invaluable assets in their own right to the everyday life of an individual living with dementia. Self-help, for those with more insight into their situation, can also be of benefit and involves activities and techniques a sufferer can do alone to boost their mood and take some time out for themselves. Talking therapies are effective methods of treating those suffering with moderate depression, in particular cognitive behavioural therapy. This involves the individual understanding and addressing the links between their thoughts, feelings and behaviours, to create positive change.

Antidepressants do have a role in treating depression that is more severe or refractory to other therapies. There are a number of drugs with different mechanisms available and a range of different options may need to be trialled and withdrawn as appropriate because their efficacy can vary greatly from person to person. This can be a timely and difficult process, firstly as the drugs in question can take weeks to have any effect, and secondly as the measurement of their effectiveness treating depression in those living with dementia is often challenging due to the communication limitations.

Depression can place a heavy burden on the individual living with dementia as well as those close to them, adding to what is an already complex disease. There have been a host of studies exploring the links between the two diseases and potential therapies for when they occur together, however many are underpowered or provide inconclusive results and I believe it would be of great benefit to the lives of many individuals if more research were carried out in this area. Most importantly, I think it is vital that depression is diagnosed and managed well in those with dementia as tackling it can provide real benefit to the person’s quality of life.

I love food, as I’m sure a lot of people do. Whether it be the smell of your favourite meal or the memory of cooking with a loved one, the majority of us would call food an experience rather than something we’re told we have to do 3 times a day. 3 years ago I committed to a vegetarian diet in order to regain a bit of control over my health. I didn’t realise it would completely reshape my relationship with food. I was even more surprised that I began to enjoy it. It’s only recently that I began to investigate some of the health benefits of certain diets. Here I’ll break down what scientists have found about diet and its impact on a person with dementia.

Over 25 years ago, scientists discovered that people on vegetarian diets experience the symptoms of dementia later in life. Meat eaters may be twice as likely than vegans to be diagnosed with dementia (Giem et al 1993). Research has been found that meat-free diets can help reduce blood pressure and the levels of fat travelling around the body. Also, vegan/vegetarian diets could be considered beneficial as they are free from the high salt content found in processed meats (de la Monte 2014). However, it is important to note that salts are present in all preserved foods – so whether you are eating preserved vegetables or preserved meats you are consuming a high level of salt. A key take-home message is that the quality of food is very important to your health.

It is also known that meat-free diets make a person more likely to suffer from a lack of vitamin B (Osimani et al 2005). A lack of vitamin B can lead to cognitive problems that can contribute to dementia if left untreated. Interestingly, a pescatarian diet (a diet free of meat but based on fish, fruits and vegetables) can reduce the severity of cognitive problems in someone who has already been diagnosed with dementia (Willams and O’Connell 2002).

If the ‘perfect diet’ does exist, we haven’t found it yet. What we do know is that even though you may not be what you eat, what you eat can have a large impact on your health. That being said, before deciding to take the drastic change in diet to veganism, it is important to remember that moderation is very important in order for lifestyle changes to be healthy and influence a long-lasting and positive change. Making your diet is balanced and appropriate for your lifestyle is more important than following any trends. Be sure to consult medical professionals before committing to drastic dietary changes.

For further reading on the subject, please visit: https://www.alzdiscovery.org/cognitive-vitality/blog/vegetarian-and-vegan-diets-for-brain-health

References

Giem P, Beeson W, L, Fraser G, E: The Incidence of Dementia and Intake of Animal Products: Preliminary Findings from the Adventist Health Study. Neuroepidemiology 1993;12:28-36. doi: 10.1159/000110296

Risk factors for dementia factsheet 2016, Factsheet 450LP Alzheimer’s Research UK Accessed 28.12.18 https://www.alzheimers.org.uk/sites/default/files/pdf/factsheet_risk_factors_for_dementia.pdf

Osimani A, Berger A, Friedman J, et al (2005) Neuropsychology of vitamin B12 deficiency in elderly dementia patients and control subjects. J Geriatr Psychiatry Neurol 18:33–38. doi: 10.1177/0891988704272308

Williams JH, O’Connell TC (2002) Differential relations between cognition and 15N isotopic content of hair in elderly people with dementia and controls. J Gerontol A Biol Sci Med Sci 57:M797-802

de la Monte SM (2014) Type 3 diabetes is sporadic Alzheimers disease: mini-review. Eur Neuropsychopharmacol 24:1954–1960. doi: 10.1016/j.euroneuro.2014.06.008

I arrived in London for this event as a sceptic about research as my remit is the here and now.

I went for curiosity and to see what was actually happening out there in the world of research.

I entered the hall at the University College of London and was greeted by an array of trestle tables and backdrops. I noticed the tea and coffee of course.

I wandered around the tables and mingled with the ever growing crowd that had gathered.

I discovered from the off the seriousness of the researchers and its importance of research to them. They were all engaged in earnest conversations with those who had attended.

I had earnest chats every stand with the people manning them. I learnt from the off what I had suspected all along. A cure or even a glimmer of hope is still at least 5-10 years away. Everyone was open and honest on that point.

The array of research on display varied from surveys to protein seeding to brain banking to visual hallucinations in dementia and Downs Syndrome.

Here is a brief overview of each.

The most impressive to me was the study by Insight 46. This is a ground-breaking study following the lives of people born in the same week in March 1946 (the maternity survey) through to a few years back. It is hoped that by mapping the lives out and seeing the changes in the lives over a lifetime that possible indicators for early detection for dementia will flag up.

I then went to see protein seeding in a test tube works. Very complex but very interesting. Proteins are taken for a select amount of people who are living with dementia and then for a similar amount who have not got the disease. The proteins are placed in a test tube to see the patterns of growth. It is fascinating to learn that in most cases the proteins multiply in a similar like pattern. The process reminded me of Lego. It is hoped that by seeing the results in a test tube the process will enable scientists to see how the proteins turn into amyloids that cause dementia in the brain (https://hamptonresearch.com>growth_101).

A little-known fact outside of dementia are is the link between Downs’ syndrome and Alzheimer’s. I chatted to some lovely people who are researching this field and how they want to use the known genetic origins of DS to understand more about the genetic causes of AD (https://www.ucl.ac.uk>about>about-ad).                                                                 

I was particularly impressed by the table looking into building the brain in a dish. They look at neurons down a scope to see the earliest signs of what’s going wrong in the brain. I looked at a scope on a screen and saw complex tangles that highlighted the formation of brain disease: stem cell research.    

I tried to build a brain from several pieces and did it in 4 mins 25 secs which sadly for me was below the average time.

There were several scientists on hand to explain the process they use in hunting for new drugs to fight the disease.  It was interesting to see the different apparatus used.

The last table I went to are people studying the interactions between memory, attention and perception and how this will help them to understand hallucinations in both Parkinson’s and Dementia with Lewy bodies. I was shown a black and white image and was asked to work out what it was. I got one part of the image correct but I guessed at the rest. It was intriguing to see how the mind relates to an image you can’t make out, so you use imagination and memory I paused for tea and scone halfway through and tweeted live from the gathering several times.

I finally left a little more enlightened on research that I was before going and although my remit on the here and now still stands, I am more of a research fan than before.

This year I had the opportunity to take part in the Reading Aloud scheme at the University of Nottingham (for details, please see: https://www.nottingham.ac.uk/english/public-engagement/shared-reading-groups.aspx#DementiaGroup), which involved reading to people with dementia at the Queens Medical Centre. Over the weeks I met many interesting people and found that the poems I read to them were often warmly welcomed not just because it was a new activity, but because the poems evoked memories of hearing and learning them in their childhood. Wordsworth's ‘I wondered lonely as a cloud’ was recognised at the first line or by the famous daffodils, and many people recited this poem along with me.

Funny poems were always popular, and everyone was amused to hear of the impossible (and often relatable!) relative in ‘Tea with Aunty Mabel’ (http://www.ourdailyread.com/2014/10/tony-mittons-top-10-poems-to-remember-and-recite/) and of Albert’s escapades in ‘The Lion and Albert’ (https://www.poemhunter.com/poem/the-lion-and-albert/).

As I introduced this latter poem on one occasion, one of the men present was able to recite all 18 verses word for word, and then mentioned other poems by Marriott Edgar which I brought along on other occasions. It was also interesting to find how the poems held significance to different people for many different reasons. One woman I met even used to write comic poetry herself, and many people had favourites because they were written by poets from their home town. Seeing the laughter and interaction sparked by poetry was a real joy of the experience.

There was one reading session that had a particular impact on me because of the effect the poetry had on the woman I was reading to. She was one of the more ill people I read to, and when I arrived at the ward she was quite confused and distressed. However, when me and one of the nurses went to sit with her, her attention turned to the poetry and offered a new focus. The light-hearted poems I read seemed to sooth her almost instantly, which I think was helped by the regular rhythm of the verses. When I then started reading a nursery rhyme, she joined in and could say it with me. I stuck with the nursery rhyme theme, which reminded her of her youth. These particular verses appeared to much lift her mood: she was a lot more relaxed and told me about her life and her job - even showing me a picture of herself taken some years ago. Within an hour’s time, she was more comfortable, aware, and happily talking with us, which was a lovely thing to witness. This particular moment stuck with me because the poetry had obviously had a profound effect and had reminded her of experiences which she could then share with us. It was evidence of the power of words and in particular poetry, and really demonstrated the positive effect that reading aloud can have.

Do you want to make a lasting impact on the lives of 850,000 people living with dementia in the UK? Do you want the chance to win £100,000 by developing a solution to support this growing challenge? Then you could be part of the next Essex Challenge Prize.

At Essex County Council we know we have to do things differently if we are to meet the challenges facing residents head on. And that’s exactly what we are doing. We have the privilege of leading a programme of work – Essex Challenge Prizes. Challenge Prizes are a pretty innovative way to commission for outcomes. They recognise that although we can be clear about the problem, there may be people out there from a diverse range of backgrounds with interesting ideas which we would never have thought of or funded through a more traditional route.

The 19th January saw us launch our second prize – Challenge Dementia. 

Challenge Dementia is a nationwide search for ambitious and innovative ideas that can support people to live well with dementia and remain connected to the people and places around them. The prize is open to anyone – individuals, groups, businesses, partnerships – who has an idea and we are keen to hear from people close to the problem, or people from an entirely different background who can bring a new perspective.

So, why dementia?  Whilst we have both been touched by dementia first hand through our families, neither of us have a professional background in health or social care. So for the past six months we have been out and about talking to a range of amazing people who are living with a diagnosis; caring for a loved one; volunteering; or working in this field.  This has helped to shape the prize and give it its focus on how we can support people to remain connected and maintain their sense of identity.   We heard time and time again how people’s worlds get smaller every day and the value people place on those connections with the people and places around them.  We have been struck by everyone’s excitement and openness to the prize and a recognition that we need to continue to look for new and innovative ways to support people living with dementia.

Our day jobs here at Essex County Council in the Corporate Strategy Team are very much focused on understanding issues and identifying possible solutions. This has been such a different experience for us, as in this process it’s not for us to come up with solutions. That’s for you to do. Instead our role, along with some fantastic support partners, is to provide support. Up to ten shortlisted finalists will be given the opportunity to work with a range of sector leaders including Business Mentors from Tech UK as well as PA Consulting, Alzheimer’s Society and the University of Essex. In addition to the non-financial support, finalists will receive a micro-grant of £5,000 each to develop and test their idea with people living with Dementia over a five month period, before presenting their Business Case in a Dragon’s Den style pitch to a panel of national judges who will decide who received the £100,000 prize in December.

The deadline for entries is the 13th April.

We are really excited to see what ideas we receive and the potential impact they will have.

At this stage we are looking for ideas with potential rather than a fully developed business case. If you’d like to find out more, do get in touch with us via our website (please visit: http://challenge-prizes.essex.gov.uk/), newsletter (https://public.govdelivery.com/accounts/UKESSEX_CHALLENGE/subscriber/new), or e-mail us at: [email protected]

And we hope to update you all in May once our finalists are announced.

Benjamin Mann and Nicole North

Essex Challenge Prize Team

Essex County Council

I've spent the past weekend at a conference on music therapy and dementia at Anglia Ruskin Univeristy, Cambridge. Astonishingly, it was a world first for a conference topic that seems to be of wide interest. 

It's clear that music therapy reaches parts that other interventions cannot reach, particularly when people are distressed or apathetic. The biggest obstacle that music therapists face, it seems, is the misconception that what they offer is just the same as a visiting concert party or an hour sat listening to Radio 2. In fact, they draw on psychodynamic theories to engage people with dementia through sound, using musical skills to respond to the person, helping them to overcome barriers to expression, and restoring identity.

Alas, there are only 125 music therapists working with older people in the UK; many of whom were at the conference, together with a strong representation of students on the 2-year MA qualifying courses. It's time for everyone working in dementia care to value music therapy and guide it to its rightful place as a highly skilled and effective resource.

Recently I saw an item on the news which reported on the therapeutic value of table tennis. Indulging in regular bouts of the game, according to new research, can lessen the symptoms of dementia and, potentially, even ward off its onset. The television broadcast featured two men, both with Alzheimer’s disease, absorbed in one long, mesmerizingly rhythmic rally that looked as though it had been going on for hours and would continue in perpetuity. (Indeed after the feature had finished, I envisaged the two men, somewhere in a leisure centre in the north of England, still returning the ball to each other, unshakeably engrossed in their eternal back-and-forth.)

The curative effects of whiff-whaff derive, the report suggested, from the physical and cognitive demands of the game. Prolonged ping-ponging may bring about (positive) changes in the brain: to wit, the enlarging of the hippocampus, a seahorse-shaped structure which plays an important role in memory function. The hippocampus is believed to shrink in people with Alzheimer’s, and hence playing ping-pong, so the theory goes, can bolster the brain, thereby countering the effects of certain strains of dementia.

This is exciting news. But where does it leave those of us with little appetite for racket sports or without ready access to a table tennis table? Fortunately, there appear to be other means of hippocampal stimulation. As I mentioned in my last blog, reading poems and stories, especially when they are read aloud and experienced with other people, has been shown to improve psychological and social wellbeing.

A charitable social enterprise based at the University of Liverpool, The Reader Organisation, has pioneered an innovative model of reading for wellbeing, known as the Get into Reading (GIR) format. The format is brilliantly simple. It involves the reading aloud of great literature to audiences in a diverse range of settings such as hospitals, community centres, care homes, corporate boardrooms and supermarkets (yes, regarding that last item in the list, you read me right). The readings are conducted by a facilitator, after which the audience, if they so wish, offer their responses to the texts. Often the discussions are personal reminiscences triggered by a particular text. And herein lies one of the key values of the format: taking part in shared reading has the potential to unearth memories which might otherwise remain submerged in the mind.

The GIR format has proved particularly popular in care homes and day centres, and recently The Reader Organisation has sought to evaluate the therapeutic benefit of shared reading in such settings. After weeks of taking part in group-reading activities, a number of participants with dementia reported positive experiences, describing, for example, how being exposed to literary language helped them to ease their minds and relax, as well as provoking concentration and stimulating new acts of thought. Similar effects were noted by staff members who described how, for group members regularly engaged in shared reading activities, the presentation of dementia symptoms was noticeably less pronounced.

Of all the variety of literary texts (short stories, poems and plays) read aloud in the groups, poetry appeared to work the best. The rhythmic cadences and transporting quality of verse were particularly appealing to group members, a number of whom spoke affectionately about the poems they had learnt and loved in their childhoods. One participant, Dan, a man who often reportedly struggled to connect with other people, was especially moved and animated by war poetry, which acted, as it were, as a kind of verbal spur, enabling him to discuss and share with others his own military experiences. After listening to a reading of Tennyson’s poem ‘The Charge of the Light Brigade’ (with its deliciously insistent, mind-etching rhythms: ‘Canon to right of them, / Canon to left of them’) and after providing fellow group members with a detailed account of the history of the Battle of Balaclava, Dan triumphantly remarked, ‘It’s still there.’

The poet WH Auden famously observed that 'poetry makes nothing happen'. Yet Dan’s (and many other people’s) experiences of poetry give the lie to such a dispiriting dictum. Granted, poetry might not be the universal panacea to all the world’s social and political ills, but it does make small, though by no means insignificant, differences to people's lives, helping them, in the context of dementia care, to reconnect with memories and enabling them in the process to articulate a sense of self.

For readers interested in learning more about shared reading as a therapeutic intervention, I recommend the original Reader Organisation report which can be accessed here.